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Please use the form to register for AskCHIS and the Public Use File downloads. If you are already registered please click here to go to the login page.

Fields that are bold are required to complete the registration process.

Login Information

User Name
Password
Repeat Password
You will need your member name & password to access the CHIS Data Query System and Public Use Files. Please use only letters, numbers and underscores.

Personal Information
First Name
Last Name
E-mail Address
Work Zip Code
Check if outside the U.S.
Type of Organization
You may select a single primary organization type. For Health Care and Human Service Providers OR Voluntary Agencies and Associations, you may also select additional definitions.

Government Agency
Federal
State
Local
Legislative Office
Federal
State
Local
Educational or Research Institution
College or university
Other research organization
Primary or secondary school
Student
College or university
Primary or secondary school
Health Insurers / Managed Care Organizations
Health Care & Human Services Providers
(Please select all that apply below)
  Health care (hospitals, clinics, physician practices, etc.)
  Human serivces
Voluntary agencies and associations
(Please select all that apply below)
  Health & health advocacy
  Grantor
  Faith-based
  Other
Consulting Organization
News Media
Other (please specify)
Use of Data
 Advocacy Conduct Research
 General Info Media Release
 Policy Action Prepare a Report
 Proposal 
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